Chronic Pimples, Boils, and Scarring—What You Can Do to Manage This Condition
If you’re struggling with chronic pimples, boils, or even scarring under the armpits, under the breasts, in the groin, buttocks, or any other skin fold areas, you might be dealing with a condition called Hidradenitis Suppurativa (HS). This can be a painful and frustrating condition, and many people don’t know where to turn for help. In this post, we’ll break down what HS is, what it looks like, and how you can better manage it, so you’re not suffering in silence.
What Is HS?
Hidradenitis Suppurativa (HS) is a chronic inflammatory skin condition that causes painful bumps, boils, and even abscesses under the skin, most commonly in areas where skin rubs together, like the armpits, groin, under the breasts, and buttocks. These areas often become inflamed and can lead to scarring, making HS not just a cosmetic concern but a condition that impacts your quality of life.
HS is typically seen in young adults, particularly those who are overweight or obese, and is more common in women. It can last for years, sometimes even decades, and it’s often misunderstood and misdiagnosed as an infection. However, HS is not an infection—you can't catch it from someone else, nor can you spread it.
Unfortunately, HS can be quite serious, leading to permanent scarring and, in the most severe cases, a reduced ability to move limbs due to the pain and inflammation. While rare, long-term HS can also increase the risk of developing skin cancer in the affected areas, so ongoing evaluation is essential.
What Causes HS?
Although the exact cause of HS is unknown (it’s considered “idiopathic”), several factors can contribute to the development of this condition. These include:
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Obesity: Overweight individuals tend to have more friction and sweat buildup in skin folds, which can trigger HS.
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Smoking: Cigarette smoking is linked to more severe cases of HS.
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Systemic conditions: HS is associated with diseases like Crohn's disease (an inflammatory bowel disease) and polycystic ovarian syndrome (PCOS).
Treatment Options for HS
Managing HS typically involves a combination of lifestyle changes and medical treatments. Early intervention is crucial to prevent scarring and reduce the severity of flare-ups. Treatment can include:
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Topical Treatments: For mild cases, topical antibiotics and other medications can help control the inflammation and prevent infection.
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Oral Antibiotics: If the condition is more persistent, doctors may prescribe systemic antibiotics to target bacteria and reduce inflammation.
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Hormonal Treatments: In some cases, hormonal therapy can help regulate the body’s inflammatory response.
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Advanced Treatments: For more severe cases, stronger medications like biologics (immunosuppressive drugs) or JAK inhibitors might be used.
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Surgical Intervention: In some situations, surgery may be needed to remove the affected tissue or drain abscesses, especially in cases that don’t respond to medication.
What Can You Do to Manage HS at Home?
While seeing a board-certified dermatologist is essential for managing HS, there are steps you can take at home to reduce flare-ups and manage the condition:
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Don’t Scrub or Over-Clean the Affected Areas HS is an inflammatory condition, not an infection, so it’s important not to treat it like one. Scrubbing, using hot water, or applying harsh soaps can irritate the skin and make the condition worse. Instead, use lukewarm water and a gentle, fragrance-free soap to wash the affected areas. Avoid antibacterial soaps unless specifically recommended by your doctor.
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Wear Loose Clothing To reduce friction and irritation, try wearing loose, breathable clothing. Tight clothes can rub against the skin and make the condition worse.
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Weight Management While not every case of HS improves with weight loss, reducing body weight can help by decreasing friction and sweat accumulation in skin folds. If you're overweight, losing weight might help reduce the frequency and severity of flare-ups.
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Quit Smoking Smoking is a known trigger for HS, and quitting can help improve the condition. Although quitting can be difficult, the health benefits, both for your HS and overall well-being, are significant.
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Stay Cool and Dry Because sweat can exacerbate HS symptoms, try to keep the affected areas as dry as possible. Use powders or moisture-wicking clothing to reduce moisture build-up.
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Consider Support Groups HS can be isolating, and many people suffer in silence, embarrassed by their condition. Joining an online or local support group can provide emotional support and helpful tips from others who understand what you’re going through.
When to See a Dermatologist
If you haven’t already, consult a dermatologist who has experience managing HS. They can help you develop a treatment plan tailored to your specific needs and guide you through the process of managing the condition over time. HS requires long-term care, and it can take 4 to 6 months to see significant improvement, so patience is key.
The Bottom Line
If you’re dealing with HS, you’re not alone. It’s a challenging condition, but with the right treatment and lifestyle changes, you can manage the symptoms and prevent the worst outcomes. The most important step is to consult with a board-certified dermatologist who has experience treating HS. They’ll help you find the right treatments and provide ongoing support.
Remember: HS is not your fault—it’s an inflammatory condition that requires specialized care. Don’t hesitate to reach out to a dermatologist and take steps to improve your health and quality of life.
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Thanks for reading and God bless.
Yuval Bibi, MD/PhD - Board Certified Dermatologist
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